Surgical Partners

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

238.000220 Issued in IL

Legal business name

SURGICAL PARTNERS

Practice address

4440 W 95TH St
Advocate Medical Group - Surgical Partners
Oak Lawn, IL 60453-2600

Phone

(312) 731-4949

NPI assigned

Aug 3, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Yaser A Maksoud, M.D.

Title

President and Ceo

Phone

(312) 731-4949

Specialties & licenses 1

Addresses

Other names 1

• Broad Enterprises, Inc. Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1861770182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437",
            "address_2": "SURGICAL PARTNERS",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604150437",
            "telephone_number": "312-731-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "address_2": "ADVOCATE MEDICAL GROUP - SURGICAL PARTNERS",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "312-731-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-03",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "MAKSOUD",
        "authorized_official_first_name": "YASER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "312-731-4949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "238.000220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broad Enterprises, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sunny Hill Personal Services, Inc.
• Christopher M Suor, O.D.
• Mary T Super, APN
• Parimal K Sura, M.D.
• Surgery Center of Illinois LLC
• Susan C Apolinario
• Suzanne Pharmacy Inc.
• Suzanne Pharmacy Inc.
• Mary E Swanson, MOT, OTR/L
• Jill Sweeney, OTR/L

• Surgical Physician Assistant in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.